SUPPLEMENT 659 



Sparganum mansoni. 



According to our present knowledge (Miyake 1 ) the disease occurs 

 almost exclusively in China and Japan. On the main island it occurs in 

 all districts, though rarely under observation. It is especially frequent 

 in the neighbourhood of Kioto and Osaka; these places are very 

 near together, and between them there is mutually active intercourse, 

 so that taken together they may be regarded as one district infested 

 by this worm disease. As regards localization in the body, there 

 appears to exist a certain predisposition for definite regions, for 

 instance, the eye and genitourinary tract. In some cases the parasite 

 manifested the peculiarity of wandering about the body and of 

 appearing at certain favourite points (muse, quadriceps femoris) 

 (Hashimoto 2 ). Most patients complain more or less of the onset of 

 attacks of pain and of sensitiveness to pressure. In those cases in 

 which the patients evacuated the worm during micturition, the 

 symptoms were variable ; sometimes there was tenesmus of the 

 bladder, sometimes pains in the inguinal region, sometimes 

 haematuria. None of these troubles is characteristic of the disease, 

 and does no more than represent the symptoms that follow a 

 mechanical irritation that any kind of foreign body may produce. 

 Besides the onset of attacks of pain, swelling of the regions affected, 

 if superficial, may often be recognized, when a superficial diffuse 

 soft tumour can be felt which often gives pseudo-fluctuation. Some- 

 times a peculiar crackling can be detected internally, as in the making 

 of a snowball. During the further course an abscess not infrequently 

 forms around the worm. When the situation of the worm is super- 

 ficial, "an inflammatory tumour with a tendency to migrate" is 

 stated by Omi 3 to be an important diagnostic sign. That, however, 

 is not always the case, as the observation made by Inoye 4 shows. It 

 would be better to add to this sign the onset of paroxysmal pain and 

 the temporary change in volume of the tumour. When once the 

 parasite is removed, the wound heals just as satisfactorily as any 

 other fresh wounds made at operation. 



Dipylidium caninum (Tcvnia ciicumerina). 



This species belongs to parasites of rare occurrence. Up to the 

 year 1905 Bollinger 5 collected thirty-six cases from the literature, 

 twenty-nine of which were children and seven adults. Since then 



1 Miyake, Mitteil. aus d. Grenzgebiete, 1904, xiii. 



- Hashimoto, quoted by Miyake. 3 Omi, Jjt-Shinsht\ Tokio, 1898. 



4 Inoye, ibid., 1897. 



3 Bollinger, Deutsch* Arch.f. klin. Med., 1905, Ixxxiv. 



